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Restricted use of glycopeptides in paediatric cancer patients with fever and neutropenia.

Abstract：

:Until now, studies confirming the safety of glycopeptide restriction in the empirical treatment of prolonged fever and neutropenia included only nine children. In an open-label observational study, the use of teicoplanin in paediatric oncology patients was investigated. A period of unrestricted use (2001-2003) was compared with a second period (2004) following implementation of a restrictive treatment guideline. Empirical first-line treatment consisted of piperacillin/tazobactam; in 2004, fosfomycin was added after 72 h as the second-line combination instead of teicoplanin. In total, 213 episodes (n=163 in 2001-2003; n=50 in 2004) managed with teicoplanin or fosfomycin (only 2004) were eligible. Empirical treatment of fever of unknown origin with teicoplanin was reduced by 97%. In 2004, the mean length of stay was 0.4 days shorter, no infection-related death occurred and no vancomycin-resistant enterococci were detected. Restriction of empirical glycopeptides is safe in paediatric cancer patients after first-line treatment with piperacillin/tazobactam. Fosfomycin appears to offer a feasible and cost-saving alternative in second-line combination therapy.

journal_name

Int J Antimicrob Agents

journal_title

International journal of antimicrobial agents

authors

Simon A,Gröger N,Wilkesmann A,Hasan C,Wiszniewsky G,Engelhart S,Kramer MH,Bode U,Ammann RA,Fleischhack G

doi

10.1016/j.ijantimicag.2006.08.007

subject

Has Abstract

pub_date

2006-11-01 00:00:00

pages

417-22

issue

5

eissn

0924-8579

issn

1872-7913

pii

S0924-8579(06)00307-4

journal_volume

28

pub_type

杂志文章

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